室系の変化から見た高血圧性脳出血の手術時期の検討

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Indication for neurosurgical treatment in the early stage of hypertensive intracerebral hemorrhage seems to be widely accepted recently. However, early treatment has been concluded with only surgical results of the hemorrhage and no conclusive reports about surgical treatment of secondary changes after intracranial bleeding with CT scan, so far, has been reported. We have experienced 78 cases of the ganglionic hematoma from 6. 1976 to 12. 1977 with CT scan. The primary changes due to hemorrhage and secondary changes developing in the vicinity of the hematoma and in the ventricles were studied. The following results were obtained. 1) The hematomas with high density on CT scanning view are completed within 3 hours after the hemorrhage attack. 2) The low density area around the hematoma shows the brain edema. It appears immediately after onset and rapidly increases to the 7th day, and reaches the maximum about the 14th day after the onset. 3) Ventricular dilation develops about 12 hours after the onset even in cases without intraventricular perforation. Those with perforation are followed by ventricular dilation within 3 hours. On clinical application of the above mentioned remarks, the operation should, in the case of intraventricular perforation, be performed as early as possible after the onset, and even in the cases without perforation surgical repair should be done within 12 hours after the onset. The prognosis in such cases will be fairly good.
The Japanese Society on Surgery for Cerebral Strokeの論文

室系の変化から見た高血圧性脳出血の手術時期の検討

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